The proportion of children in the population fell to an all-time low of 13.5 percent. That number has been falling for 34 straight years and is the lowest among 31 major countries, according to the report. In the United States, children account for about 20 percent of the population.

European and Japanese non-immigrant populations have fallen well below replacement, and that means they’ll be substantially different in 20-30 years.

Suture for a Living: Grand Rounds 4:33
I had no theme for this Grand Rounds, but thought I would share some links and photos of Arkansas. This first one is of the Trail of Tears (photo credit). This first post may well bring tears to your eyes –

“It is irrational to believe that an emergency system that is already overwhelmed by the day-to-day volume of acutely ill patients would be able to expand its capacity on short notice,” said Dr. Roger J. Lewis, a professor in the Department of Emergency Medicine at Harbor-UCLA Medical Center.

All the ED’s I’m aware of work at or above capacity daily. There’s room for maybe a 6 hour surge, but that’s only if most of the patients brought in the surge go home from the ED. I don’t want to think about pandemic flu, let alone some weaponized bug.